We propose to establish a Mexican American Effectiveness Research Center (MERECR) to study treatment effectiveness for chronic disabling conditions n Mexican Americans. We have chosen chronic disabling conditions because they represent a disproportionate burden of illness and because culture and language are more likely to influence treatment conditions. The specific aims of the Research Core are: 1. to identify chronic diseases or disabilities whose outcomes have the most variability or which occur at an increased frequency in the Mexican American population; 2. to assess the cultural appropriateness and validity of available outcome measures (such as functional status, quality of life, utilities and costs) for the Mexican American population and to develop and validate translations as well as new instruments as necessary; 3. to develop a methodology for assessing cultural appropriateness of a medical intervention; 4. to assess the effectiveness of medical interventions o outcomes of chronic diseases and disabling conditions in the Mexican American population. There are 8 on-going and 11 proposed projects in the Research core. The goal of the Training Core will be to recruit and train investigators to perform outcomes research within the Mexican American population. Programs will include a seminar series for core staff, a visiting lecturer program, a scholar program for non MERECE faculty and community researchers, a flexible curriculum for pre and post doctoral students leading to a PhD or MPH, and research electives for medical students and housestaff. Recruitment of Mexican Americans within each of these programs will be emphasized. The specific aims of the Technical Assistance Core (TAC) are: 1. to support MERECE research, education, and dissemination projects; 2. to solicit, develop, and review external proposals relevant to MERECE's mission; 3. to develop a network and directory of researchers, policymakers, and granting agencies interested in minority research related to chronic disabling conditions; and 4. to establish a liaison with the Clearing House on Health Indexes with the aim of clearly delineating and cataloging which indices are feasible and validated for use in Mexican Americans. The TAC will provide: a) an internal review process for proposals, papers articles, presentations, and videotapes; b) training, consultative and collaborative services for MERECE affiliated staff and community researchers; c) development and validation of culturally appropriate functional status and other outcome measures and interventions for use in MERECE related projects. The specific aims of the Dissemination Core (DC) are 1. Disseminate information on medical outcomes research targeted to appropriate health, governmental, community organizations. 2. Disseminate and evaluate the impact of medical outcomes research. 3. Provide intimate communication linkage among MERECE participants and relevant counterparts. 4. Identify the most effective methods of dissemination of medical outcomes information to Mexican Americans. The DC will facilitate the regular transfer and discussion of information that will: a) enhance the progress of medical outcomes research, training and technical assistance and b) form a basis for health policy development and implementation.